Policy Timeline

Key Governmental, Agency, and Institutional Policies related to Sex and Gender Research

Below are important policy developments in the European Union (EU), United Kingdom (UK), United Nations (UN), Spain (ES), and United States (US).

1960s

US: Women's Health Movement. Local and national groups began drawing attention to how the US health care system failed women. These included the Boston Women's Health Book Collective, the National Women's Health Network, and later the National Black Women's Health Project and consumer lobbies for the treatment and prevention of breast cancer. Activists in these groups questioned male control of the health professions, encouraged women to enroll in medical schools, challenged sexism in traditional medical curricula, and fought to license midwives and to improve women's knowledge of their bodies.

UK: Women's Health Movement. Activists began challenging the longstanding medical stereotype of women as "sickly creatures" and sought to increase women's control over their own bodies through access to contraception and other reproductive technologies.

1963

US: Equal Pay Act.The US Federal Employment Opportunity Commission required that "men and women in the same workplace be given equal pay for equal work."

1964

US: Civil Rights Act of 1964.This Act broadly prohibited employers and labor unions from discriminating on the basis of sex in hiring, compensation, training, promotion, or representation. Employment practices intended to discriminate were also prohibited, even if the discriminatory elements were not explicit. This Act was ammended in 1972 to prohibit discrimination in education and in 1978 to prohibit pregnancy discrimination.

1967

US: Affirmative Action Applied to Women. Lyndon B. Johnson’s Executive Order 11375 amended Executive Order 11246 to require that certain federal contractors “take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex or national origin.”

1972

US: Equal Employment Opportunity Act. This Act amended the Civil Rights Act of 1964 and prohibited discrimination in hiring and promotion on the grounds of an employee or perspective employee's sex, race, color, religion, or national origin. Religious institutions, employers with fewer than fifteen employees, and certain Federally- and Native American-owned enterprises were exempt.

US: Title IX of the Education Act Amendments. Lawmakers recognized that sex discrimination in education limited women's equality in the workforce even when employers were prohibited from engaging in such discrimination. Title IX prohibits sex discrimination in all programs of all educational institutions, public and private, which receive federal funding.

1975

EU: European Council Equal Pay Directive. The European Council required Member States to eliminate “all discrimination on grounds of sex with regard to all aspects and conditions of remuneration.” The Directive gave rise to legal, regulatory, and administrative means of ensuring equal pay for equal work.

1976

EU: European Council Equal Treatment Directive. This Directive required EU Member States to establish the equal treatment of women and men "in regards to access to employment and vocational training and promotion and as regards working conditions.” In 2002, this Directive was revised to include a formal ban against sexual harassment.

1977

US: First Meeting of the Congressional Caucus for Women's Issues. This bipartisan Caucus has worked to address pregnancy discrimination, child support enforcement, and the inclusion of women in clinical trials. Most recently, it has developed legislation to increase women's and minorities' representation in science and engineering disciplines.

1978

EU: European Council Equal Treatment on Social Security Directive. This Directive required Member States to implement the “principle of equal treatment in matters of social security” including “statutory schemes which provide protection against the risks of sickness, invalidity, old age, accidents at work, occupational diseases and unemployment, and in social assistance in so far as it is intended to supplement or replace the abovementioned schemes.”

US: Equal Opportunity in Science and Engineering Act. This Act directs the National Institutes of Health (NIH) and National Science Foundation (NSF) to increase the participation of underrepresented groups in medicine, science, and engineering. Funding has been set aside to achieve these ends.

1982

US: Report on Women and Minorities in Science and Engineering. The NSF published the first congressionally-mandated report on diversity in science and engineering fields. Persons with disabilities were added in 1984. This report revealed that women, and African-American men, were significantly underrepresented in technical fields.

US: NSF Establishes Career Advancement Awards (CAAs). The NSF targeted junior women scientists for these awards, which often came at critical transition times in their careers. CAAs provided funding of up to $175,000 over two years.

1990

US: Women's Health Equity Act (WHEA). The WHEA called for establishing a permanent office of women and health under the Assistant Secretary of Health, charged with overseeing the inclusion of women in research studies and supporting research into diseases affecting women. Though never passed, the WHEA contained several provisions which were incorporated into other successful bills. Most importantly, the WHEA increased awareness that excluding women from clinical trials, once seen as a form of "protectionism," was a long-term threat to equality in medical research.

US: Report on Problems in Implementing Policy on Women in Study Populations. This report, published by the General Accounting Office (GAO, changed to General Accountability Office in 2004), found that "the NIH has not adequately implemented its policy" to encourage the inclusion of women in clinical studies. Investigators discovered inconsistent and generally weak enforcement of NIH policies, particularly in terms of grant evaluation, and raised concerns that the NIH had no effective plans to monitor its own progress. Recommendations for improvement were implemented.

US: Office of Research on Women's Health (ORWH) Founded. The ORWH was established with two mandates. First, it was to increase the number of women involved in health research. Second, it was charged with reconceptualizing medical research to include subjects of both sexes in support of analysis of sex differences. Importantly, the concept of women's health expanded beyond a narow focus on disorders associated with the female reproductive system to encompass other diseases that create significant burdens in women's lives.

US: Breast and Cervical Cancer Mortality Prevention Act. This Act established a National Breast and Cervical Cancer Early Detection Program as part of the Centers for Disease Control and Prevention (CDC). In addition, Medicaid coverage was expanded to include funding for mammograms and Pap smears.

US: NIH Establishes Faculty Awards for Women (FAW). Previous NSF programs supported women and minority scientists in the earlier stages of their careers, but FAW was the first program to specifically address the lack of women in senior positions. FAW supported faculty research projects with grants up to $250,000 over five years, and was highly effective at helping recipients achieve tenure.

1991

US: Women's Health Initiative. The NIH established this initiative "to address the most common causes of death, disability and impaired quality of life in postmenopausal women." In accordance with the Initiative, the NIH supported research into prevention, diagnosis, and treatment of diseases including osteoporosis, cardiovascular disease, and various cancers.

1992

EU: European Council Directive on Maternity Leave and Health and Safety Conditions for Pregnant and Nursing Mothers. The Council set out policies that Member States must adopt to ensure the health and safety of workers who are pregnant, have recently given birth, or are breastfeeding. Member States are required to make maternity leave compulsory for at least two weeks (that is, to prohibit people from working within 2 weeks of having given birth) and to ensure workers’ rights to maternity leave of at least 14 continuous weeks. Member States are also required to ensure that persons on maternity leave receive an “adequate allowance,” at minimum equivalent to the allowance that would be provided if the worker in question were unable to work due to injury. Finally, Member States are required to prohibit termination on the grounds of pregnancy and related conditions, to prohibit work practices which would expose pregnant or breastfeeding workers to unsafe conditions, and to prohibit compulsory night work for pregnant women and those having recently given birth.

US: Mammography Quality Standards Act. The Food and Drug Administration (FDA) established a system of certification for all mammography facilities, excluding those operated in association with Veteran's Affairs (VA) hospitals. All covered facilities were required to adhere to standards regarding interpretation of mammograms and minimization of patient's radiation dosages.

US: Report on Women in Prescription Drug Testing. The GAO issued a Congressional report finding that the FDA failed to ensure that women were included in clinical drug trials. In most cases, the proportion of women amongst clinical trial subjects for a particular drug was substantially smaller than the proportion of women amongst the population of prospective patients. The FDA also failed to require analysis of sex differences in drug response.

1993

US: NIH Health Revitalization Act. (Public Law 103-43, Subtitle B, Clinical Research Equity Regarding Women and Minorities) Congress required that NIH grantees include women and minority groups in human subjects research and, for clinical trials, "ensure that the trial is designed and carried out in a manner sufficient to provide for a valid analysis of whether the variables being studied in the trial affect women or members of minority groups, as the case may be, differently than other subjects in the trial." Cost was not allowed as an acceptable reason for exclusion. However, the law applied only to clinical trials, leaving women and minorities out of the discovery phases. (Guidelines for the inclusion of women in federally-funded research had been in place at NIH since 1986 but not enforced). Significant exceptions to the Act include studies in which the participation of women and minorities would be "inappropriate with respect to the health of subjects" or "with respect to the purpose of the research" or under "such circumstances as the Director of NIH may designate." The NIH implemented policies in compliance with the act in 1994 (see below).

US: Guidelines for Study of Gender Differences in Clinical Evaluation of Drugs. The FDA publishes new guidelines that reverse its 1977 guidelines barring women of childbearing potential from participating in clinical research (including phase I and II studies). The guidelines also require analysis of data on sex differences. Further, the FDA encourages the study of drug interactions with 1) menstrual cycles, 2) exogenous hormone therapy, and 3) oral contraceptives, when feasible.

US: Report on Women in Biomedical Careers. This ORWH report investigated the obstacles women face in advancing biomedical careers, from a lack of female role models to the unequal burden of childcare they often shoulder. It includes strategies to help recruiters attract qualified women to biomedical positions.

US: Recruitment and Retention of Women in Clinical Studies. The ORWH and Department of Health and Human Services addressed how medical research could meet the requirements of the NIH Revitalization Act and examined the challenges to including and retaining women in clinical studies. Solutions involving institutional reform, study redesign, and community-level involvement were put forward.

1995

European Council Action Programme on the Equal Opportunities for Women and Men. The European Council promoted gender mainstreaming through the “integration of equal opportunities in the process of preparing, implementing, and monitoring all policies, measures, and activities at Community, national, regional and local” levels. The Action Programme supports goals including gender equality, work-life balance, and economic competitiveness.

UN: The United Nations Fourth World Conference on Women. The UN established a Platform for Action which includes provisions for “mainstreaming a gender perspective in all policies and programmes so that before decisions are taken, an analysis is made of the effects on women and men, respectively.” The Platform supports government actions to increase women’s participation in leadership within public and private organizations and to combat discrimination within government-funded organizations.

US: Report on Mammography Inspections. The GAO found that the FDA's monitoring of the more than 10,000 US mammography facilities, mandated according to the 1992 Mammography Quality Standards Act, had significantly reduced the incidence of irresponsible practices. However, the GAO noted that the FDA needed to develop more consistent test protocols, keep better records to identify facilities which are "repeat offenders," and act more promptly to shut down poor-quality facilities.

1998

EU: Council of Europe Defines Gender Mainstreaming. The European Council defined gender mainstreaming as "the (re)organisation, improvement, development and evaluation of policy processes, so that a gender equality perspective is incorporated in all policies, at all levels and at all stages, by the actors normally involved in policymaking." The Council further identified best practices for gender mainstreaming.

EU: European Technology Assessment Network (ETAN) Founded. The European Commission establishes ETAN as a working group of female scientists and is assigned the tasks of collecting national-level data on women in science, and proposing recommendations to address gender in research and the balancing of scientific careers and family life.

EU: Progress Report on Equal Opportunities Published. The European Commission reviewed advances in gender mainstreaming and identified strategies for further progress, including routine gender impact assessments of all policies, increasing financial and human resources in gender expertise, and monitoring of policies and outcomes to reduce disparities.

EU: Amsterdam Treaty. First drafted in 1997, this treaty requires all EU member states to take concrete action against "discrimination based on sex, racial or ethnic origin, religion or belief, disability, age, or sexual orientation" and makes gender mainstreaming a legal requirement.

EU: Women and Science Action Plan. The Helsinki Group on Women in Science is established with a directive to "bring together networks of women scientists and organisations committed to gender equality in scientific research" and monitor women's participation in the sciences throughout the EU.

US: NIH Has Increased Its Efforts to Include Women in Research. The GAO reports that the NIH had improved representation of women as research subjects, and cites the ORWH's involvement as key to this achievement. GAO reports, however, that less progress has been made in data analysis of sex differences that might reveal whether interventions affect women and men differently.

EU: Women and Science Unit Founded. The Women and Science Unit formed to coordinate the collection of comparable statistics on women in science in all EU Member States. The resulting data have been used to address gender issues in research funding, measurements of productivity, etc.

EU: High Level STRATA-ETAN Expert Group. The European Commission asks academics, gender experts, industrialists, and human resource representatives from international companies with significant research departments to form a working group; The group's task is to analyze women researchers in the private sector.

2002

EU: Sixth Framework Programme (FP6). The EU ammended its ethical research principles to include increasing the roles of women in research. Under FP6, the EU gave special consideration to projects that increased public awareness of women in science or female students' exposure to research. These requirements were described in greater detail in a 2003 Vademcum. EU: Enlarge Women in Science to the East (ENWISE) Expert Group. The European Commission enlarged its 1998 ETAN group to include experts on the status of women in science in Central and Eastern European Countries, the Baltic States, the new Eastern states of Germany, and the Balkan Region. This group carried out research in support of the EU's Science and Society Action Plan to "promote gender equality in science in the wider Europe."

EU: Vademecum on Gender Mainstreaming in the 6th Framework Programme. This document offered a blueprint for how to design sex and gender analysis into basic research. Its intended audience was scientific project officers. The EU required that grantees address "whether, and in what sense, sex and gender are relevant in the objectives and the methodology of the project." This requirement was scaled back in FP7 because researchers lacked an understanding of how to do sex and gender analysis.

EU: She Figures. A major European Union publication presenting EU-wide data on women in science, starting from tertiary education through to employment. More recent figures were published in 2006 and 2009.

US: Heart Disease Education, Analysis Research, and Treatment (HEART) for Women Act. This congressional proposal, never enacted, would have compelled the FDA to report sex-disaggregated patient safety data for drugs and to investigate sex disparities in treatment for cardiovascular disease (CVD). Further, the act required the FDA to produce educational materials to counter the widespread belief that CVD is primarily a health problem for men; in reality, CVD is the number one killer of US women as well.

EU: Monitoring Progress Toward Gender Equality in the Sixth Framework Programme a Synthesis . The report summarizes how successfully gender was integrated into the thematic priorities of the Sixth Framework Programme. Although women's representation in research increased since 2001, most of this progress was made in less senior roles; a lack of work-life balance and stereotypically masculine workplace cultures were identified as major obstacles to gender equality. When gender in the research content was considered, biological differences tended to be explored without due regard to the socio-economic aspects which were often just as important.

EU: Negotiation Guidance Notes in The Seventh Framework Programme. The guidelines state that collaborative projects funded by the Seventh Framework Programme must "ensure an open and impartial selection procedure, as well as fair working conditions, to researchers recruited for work." However, gender mainstreaming of research was not specifically addressed.

EU: Gender Mainstreaming Implemented as part of the Spanish Innovation Strategy.Spain's National Plan for Research and Technological Development now requires gender analysis in "all aspects of the [research] process: definition of priorities of scientific and technological research [...] theoretical and explanatory frameworks, methods, collection and interpretation of data, and findings." The legislation also requires collection of sex-disaggregated data and promotes sex-and race-blind assessment processes for researchers in order to combat discrimination.

US: American College of Cardiology Requires Sex Analysis.The editorial board of the Journal of the American College of Cardiology amended its instructions to authors, requiring researchers to "provide gender-specific data, when appropriate, in describing outcomes of epidemiologic analyses or clinical trials" or "specifically state that no gender-based differences were present."

US: American Heart Association Requires Sex Analysis.The editors of the journal Circulation added instructions requesting prospective sex analysis in published papers. These developments are significant as CVD research is one of the medical fields in which women have been most chronically underrepresented.

US: National Institutes of Health (NIH) releases guidelines for considering sex in preclinical research. NIH states that "accounting for sex as a biological variable begins with the development of research questions and study design. It also includes data collection and analysis of results, as well as reporting of findings. Consideration of sex may be critical to the interpretation, validation, and generalizability of research findings. Adequate consideration of both sexes in experiments and disaggregation of data by sex allows for sex-based comparisons and may inform clinical interventions. Appropriate analysis and transparent reporting of data by sex may therefore enhance the rigor and applicability of preclinical biomedical research."